IN THE CASE OF:	 

		BOARD DATE:	  22 October 2013

		DOCKET NUMBER:  AR20130000798 


THE BOARD CONSIDERED THE FOLLOWING EVIDENCE:

1.  Application for correction of military records (with supporting documents provided, if any).

2.  Military Personnel Records and advisory opinions (if any).


THE APPLICANT'S REQUEST, STATEMENT, AND EVIDENCE:

1.  The applicant requests, in effect, his medical records be corrected to show he was diagnosed with post-traumatic stress disorder (PTSD) while in service.

2.  The applicant states, in effect, they failed to diagnose him with PTSD while in service as evidenced by the diagnosis of PTSD by the Veterans Center. 

3.  The applicant provides:

* U.S. Army Combined Arms Support Command (CASCOM), Fort Lee, VA, Orders 271-00449, dated 28 September 2001
* CASCOM Orders 285-00261, dated 12 October 2001
* CASCOM Orders 303-00273, dated 30 October 2001
* CASCOM Orders 241-00204, dated 29 August 2007
* Chronological Records of Medical Care from the Kenner Army Health Clinic Mental Health Clinic and Psychiatry Clinic, dated between
4 September 2007 and 6 February 2008
* a Memorandum for Record (MFR), dated 11 October 2007, from 
Dr. B____, MD, PhD, U.S. Army Medical Department Activity Fort Lee, VA
* DA Form 3974 (Medical Evaluation Board (MEB) Proceedings), dated 
15 October 2007
* DA Form 199 (Physical Evaluation Board (PEB) Proceedings), dated 
30 October 2007
* DA Form 18 (Revised PEB Proceedings), dated 31 January 2008 and
16 February 2011
* CASCOM Orders 038-0503, dated 7 February 2008
* DD Form 214 (Certificate of Release or Discharge from Active Duty) with a separation date of 30 April 2008
* Veterans Center interview form, dated 19 June 2008
* U.S. Army Physical Disability Agency (USAPDA) Orders D0459-20, dated 18 February 2011
* a list of his medications, updated April 2008
* a Department of Veterans Affairs (VA) Form 21-4138 (Statement in Support of Claim)

CONSIDERATION OF EVIDENCE:

1.  On 24 September 1986, he enlisted in the Regular Army and served on active duty continuously until his retirement and placement on the Temporary Disability Retired List (TDRL).  

2.  On 30 September 2001, he was ordered to deploy in support of Operation Enduring Freedom.  He was assigned to the Military Assistance Program Support Office, Navy Support Activity, Bahrain.  

3.  The medical records he submitted show he was treated for:

* depression by a social worker on 4 September 2007
* mood disorder by a psychiatrist on 24 September 2007
* adjustment disorder with depressed mood by a licensed clinical social worker (LCSW) on 21 December 2007
* major depression recurrent severe with psychotic features by a physician on 21, 26, and 31 December 2007, on 10 and 17 January 2008, and on 
6 February 2008
* major depression recurrent moderate by a licensed clinical psychologist on 31 December 2007, and on 8, 10, and 23 January 2008
* major depression recurrent moderate by a physician on 18 January 2008

4.  An MFR, dated 11 October 2011, from the staff psychiatrist at the U.S. Army Medical Department Activity stated the applicant had been diagnosed with depression and depression due to a general medical condition.  He stated these conditions were not medically disqualifying conditions but should be included among the applicant's current diagnoses.

5.  On 15 October 2007, an MEB referred the applicant to a PEB for:

* acromegally (a rare disease that occurs when the body makes too much growth hormone and IGF-I) (medically unacceptable)
* pituitary neoplasm benign but hormone secreting (medically unacceptable)
* panhypopituitarism (absence or damage of the pituitary gland (medically unacceptable)

6.  The MEB found the applicant's following conditions as medically acceptable:

* ankylosing spondylitis
* depression

7.  On 30 October 2007, an informal PEB was convened.

	a.  The applicant was found physically unfit for acromegaly secondary to a  benign pituitary adenoma presenting initially with headaches in 2004 treated with surgery and radiation.  A disability rating of 30 percent was recommended.

	b.  MEB diagnoses for ankylosing spondylitis and depression met medical standards.

	c.  The PEB recommended a combined rating of 30 percent and that the applicant be placed on the TDRL with a reexamination during March 2009.  

8.  On 14 December 2007, a formal PEB was convened.

	a.  The applicant was found unfit for duty due acromegaly secondary to a benign pituitary adenoma presenting initially with headaches in 2004 treated with surgery and radiation.  A disability rating of 60 percent was recommended.

	b.  MEB diagnoses for ankylosing spondylitis and depression met medical standards.

	c.  The PEB recommended a combined rating of 60 percent and that the applicant be placed on the TDRL with a reexamination during September 2009.  

9.  On 31 January 2008, revised PEB Proceedings reflected a change in the VA codes used.  There were no changes to disabilities, percentages, or recommendations.  The formal PEB was approved on 31 January 2008.

10.  On 30 April 2008, he was retired and placed on the TDRL on 1 May 2008.  He completed 21 years, 7 months, and 7 days of active service that was characterized as honorable.

11.  He submitted the results of an evaluation, conducted on 19 June 2008, by an LCSW at a Veterans Center in Richmond, VA.  

	a.  He was seeking assistance with problems he had been having since he served during Operation Enduring Freedom.  He had sleep difficulties, nightmares, depressed moods, concentration problems, and he was often forgetful.

	b.  He described a traumatic experience in a shopping area in Bahrain during an anti-American demonstration.

	c.  The LCSW diagnosed him with PTSD under Axis I.

12.  On 16 February 2011, an informal TDRL PEB found him to be permanently unfit for duty for:

* acromegaly with a disability rating of 60 percent
* hypopituitarism due to treatment for acromegaly, rated analogously to Addison's, with a disability rating of 20 percent

13.  The PEB stated the MEB diagnoses of ankylosing spondylitis and depression were medically acceptable as stated on the original DA Form 199, dated 31 January 2008.

14.  The PEB recommended a combined rating of 70 percent and that the applicant be permanently retired due to disability.

15.  On 18 February 2011, he was removed from the TDRL and placed on the Retired List with a disability rating of 70 percent.

16.  He submitted a statement from Sergeant First Class (SFC) G_____, dated 
12 May 2011.  SFC G_____ stated the applicant was a member of her team at a supply warehouse located at the Navy Central Command Base in Bahrain from October 2001 - May 2002.  She stated they were in a constant state of paranoia due to living out in the city of Manama and having to be vigilant at all times and aware of their surroundings.  They were required to change their travel routes daily and could not fall into a routine due to the heightened threat levels.  They were required to search their cars for explosives every morning.

17.  Department of Defense Instruction 1332.38 (Physical Disability Evaluation) states, in pertinent part, that conditions newly diagnosed during a TDRL periodic physical examination may be compensable only if the condition is unfitting and the condition was caused by the condition for which the member was placed on the TDRL, or directly related to its treatment; or the evidence of record establishes that the condition was either incurred while the member was entitled to basic pay or as the proximate result of performing duty, whichever is applicable, and was an unfitting disability at the time the member was placed on the TDRL.  Otherwise, such conditions shall be deemed unfitting due to the natural progression of the condition and non-compensable.

DISCUSSION AND CONCLUSIONS:

1.  There is no evidence in the applicant's records and he provides no evidence to support his contention that he suffered from PTSD during his military service.  The service medical records he submitted show extensive treatment for depression.  The MEB and all of his PEB's determined that his depression was not unfitting for military service.

2.  He was diagnosed with PTSD after he was placed on the TDRL.  A condition diagnosed while on the TDRL may be compensable only if the condition was found unfitting and the condition was caused by a condition for which the member was placed on the TDRL.  His diagnosis of PTSD is not related to the conditions for which he was placed on the TDRL.

3.  Without evidence to the contrary, diagnoses and observations made by medical personnel present at the time of treatment or admission to medical facilities are accepted as representative of the facts.

4.  Comments made in a psychiatric report are usually not made.  Almost by definition, a psychiatrist or mental health official must note personal impressions rather than physical conditions in making a diagnosis.  It is presumed the applicant was evaluated by competent military medical personnel and therefore finds no reason to change the psychiatrist's or the mental health official's diagnosis of depression.

5.  In any case, for historical purposes, the Army has an interest in maintaining the integrity of its records.  The data and information contained in those records should reflect the conditions and circumstances that existed at the time the records were created.  In the absence of a showing of material error or injustice, there is a reluctance to recommend that those records be changed.  

6.  Therefore, absent convincing independent and verifiable evidence to the contrary, it is presumed that the applicant's military service records, including his medical records, were correct at the time and there is insufficient evidence to grant him relief in this case.


BOARD VOTE:

________  ________  ________  GRANT FULL RELIEF 

________  ________  ________  GRANT PARTIAL RELIEF 

________  ________  ________  GRANT FORMAL HEARING

____x___  ___x____  ____x____  DENY APPLICATION

BOARD DETERMINATION/RECOMMENDATION:

The evidence presented does not demonstrate the existence of a probable error or injustice.  Therefore, the Board determined that the overall merits of this case are insufficient as a basis for correction of the records of the individual concerned.




      ___________x_____________
               CHAIRPERSON
      
I certify that herein is recorded the true and complete record of the proceedings of the Army Board for Correction of Military Records in this case.

ABCMR Record of Proceedings (cont)                                         AR20130000798



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ABCMR Record of Proceedings (cont)                                         AR20130000798



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